Format

Send to

Choose Destination
J Diabetes Complications. 2015 Jan-Feb;29(1):20-5. doi: 10.1016/j.jdiacomp.2014.09.006. Epub 2014 Sep 16.

Is depression a risk factor for diabetic foot ulcers? 11-years follow-up of the Nord-Trøndelag Health Study (HUNT).

Author information

1
Faculty of Health and Social Sciences, Bergen University College, PO Box 7030, N-5020 Bergen, Norway; Department of Endocrinology, Stavanger University Hospital, PO Box 8100, 4068 Stavanger, Norway. Electronic address: marjolein.iversen@hib.no.
2
Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020 Bergen, Norway.
3
Faculty of Health and Social Sciences, Bergen University College, PO Box 7030, N-5020 Bergen, Norway.
4
The HUNT Research Center, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway.
5
Duke Global Health Institute, Duke University, Box 90519 Durham, NC 27708, USA.

Abstract

AIM:

To prospectively examine whether depressive symptoms increase the risk of diabetes and a diabetic foot ulcer.

METHODS:

The Nord-Trøndelag Health Study (HUNT) is a community-based longitudinal study. The Hospital Anxiety and Depression Scale (HADS-D subscale) assessed depressive symptoms. We followed individuals with complete HADS-D data from HUNT2 (1995-97) and assessed whether they reported diabetes with or without a history of diabetic foot ulcer (DFU) in HUNT3 (2006-08) (n=36,031). Logistic regression was used to investigate the effect of depressive symptoms on subsequent development of diabetes and of DFU.

RESULTS:

Unadjusted odds for reporting diabetes at follow-up was higher among individuals who reported a HADS-D score≥8 at baseline (OR 1.30 95% CI, 1.07-1.57) than among those reporting a lower score. After adjusting for age, gender and BMI, this association was no longer significant. The odds of developing a DFU was almost two-fold (OR=1.95 95% CI, 1.02-3.74) for those reporting a HADS-D score of 8-10, and 3-fold (OR=3.06 95% CI, 1.24-7.54) for HADS-D scores≥11, compared to HADS-D scores<8, after adjusting for age, gender and serum glucose.

CONCLUSIONS:

Symptoms of depression at baseline are associated with an increased risk of a diabetic foot ulcer in a dose response manner during this 11-year follow-up.

KEYWORDS:

Cohort study; Depression; Diabetes; Foot ulcer; Norway; Risk factor

PMID:
25283486
DOI:
10.1016/j.jdiacomp.2014.09.006
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center